Could it be pudendal nerve if no pain in genital area?
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Hopeless74
- Posts: 2
- Joined: Mon Sep 18, 2023 7:34 pm
Could it be pudendal nerve if no pain in genital area?
Hi, I'm new here, I don't have diagnose but I have had mysterious pain over 3 years. My pains are in sacrum and buttock are, not in anal or genital area. I also had pain in in my coccyx but it operated 2 years ago and I don't have coccyx pain anymore. Gynegologo found painful area from vagina but she didn't find any reason for that. Could it be pudendal nerve if genital or anus area are not any pain? This pain kill me, I don't have normal life anymore, doctors don't know why i have pain, they just give me more medicin but I don't get help from them. My own doctor Google found information about pudendal nerve I I'm thinkin could it be my problem.
Re: Could it be pudendal nerve if no pain in genital area?
Hello Hopeless74,
That's discouraging when you don't have a diagnosis because then it's harder to figure out a treatment. Have your doctors done any imaging - like MRI of the lumbosacral spine or pelvic area?
Typically, with pudendal neuralgia there is some pain in the genital and/or anal area. You said that your doctor found pain in the vaginal area. The pudendal nerve innervates part of the vagina so that could potentially be a symptom of pudendal neuralgia and was actually one of my primary symptoms when I had pudendal neuralgia. Also, one of the symptoms of pudendal nerve entrapment is tenderness when the doctor presses on the ischial spine inside the vagina. (The ischial spine is not part of the spine in your back. You can see where it is if you go to the anatomy page on our website.) There can also be painful muscles such as the obturator internus or levator ani inside the vagina, and the pudendal nerve runs through the Alcock's canal between those two muscles that make up a large part of the vagina. So, I don't know where exactly the vaginal pain was that your doctor found and I can't say for sure if it's pudendal neuralgia for you. But it's something your doctors need to figure out and if they can't, maybe you will need to travel to see a pudendal specialist.
Regarding the sacral and buttock pain there are many things that can cause those. My experience was that I had bad ligaments, and I had a bunch of musculoskeletal issues along with pudendal neuralgia, including, SI joint dysfunction, pelvic instability and misalignment, and piriformis syndrome. So I had buttock pain in addition to pudendal neuralgia. Often pudendal neuralgia occurs along with other problems in the pelvis so it can be difficult to determine the root cause of the pain. A good physical therapist or manual therapist might be able to help you figure out if there are some musculoskeletal issues contributing to your pain. Have you had a chance to see a PT yet? I was actually diagnosed with PN by a physical therapist when my doctors couldn't figure out what was going on. They did an internal exam and pressed on the ischial spine and that area was very tender.
Anyway, I wish you luck as you try to get this figured out. It can be a pain in the butt just having to go to so many medical appointments, right?
Violet
That's discouraging when you don't have a diagnosis because then it's harder to figure out a treatment. Have your doctors done any imaging - like MRI of the lumbosacral spine or pelvic area?
Typically, with pudendal neuralgia there is some pain in the genital and/or anal area. You said that your doctor found pain in the vaginal area. The pudendal nerve innervates part of the vagina so that could potentially be a symptom of pudendal neuralgia and was actually one of my primary symptoms when I had pudendal neuralgia. Also, one of the symptoms of pudendal nerve entrapment is tenderness when the doctor presses on the ischial spine inside the vagina. (The ischial spine is not part of the spine in your back. You can see where it is if you go to the anatomy page on our website.) There can also be painful muscles such as the obturator internus or levator ani inside the vagina, and the pudendal nerve runs through the Alcock's canal between those two muscles that make up a large part of the vagina. So, I don't know where exactly the vaginal pain was that your doctor found and I can't say for sure if it's pudendal neuralgia for you. But it's something your doctors need to figure out and if they can't, maybe you will need to travel to see a pudendal specialist.
Regarding the sacral and buttock pain there are many things that can cause those. My experience was that I had bad ligaments, and I had a bunch of musculoskeletal issues along with pudendal neuralgia, including, SI joint dysfunction, pelvic instability and misalignment, and piriformis syndrome. So I had buttock pain in addition to pudendal neuralgia. Often pudendal neuralgia occurs along with other problems in the pelvis so it can be difficult to determine the root cause of the pain. A good physical therapist or manual therapist might be able to help you figure out if there are some musculoskeletal issues contributing to your pain. Have you had a chance to see a PT yet? I was actually diagnosed with PN by a physical therapist when my doctors couldn't figure out what was going on. They did an internal exam and pressed on the ischial spine and that area was very tender.
Anyway, I wish you luck as you try to get this figured out. It can be a pain in the butt just having to go to so many medical appointments, right?
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Hopeless74
- Posts: 2
- Joined: Mon Sep 18, 2023 7:34 pm
Re: Could it be pudendal nerve if no pain in genital area?
Thanks Violet
MRI has been taken from back and pelve area. There are smal prolaps and annalusdamages (I'm not sure if this right term in English) in L4/5 and L5/S1. But this damages are small and don't pressure nerves. Cemical irritation is possible but I get nerve block for S1 nerve and it did't help, or there was one day without pain after two days for block. There was also cortisone on this block but no longer help so this one day could be just coincidence. I have get cortisone injection also for SI-joint and piriformis but without any help for the pain. I have seen physioterapist many many times ang get trainee programs, thesa are for back and pelve area.
And yes, I really have seen so many doctors...
MRI has been taken from back and pelve area. There are smal prolaps and annalusdamages (I'm not sure if this right term in English) in L4/5 and L5/S1. But this damages are small and don't pressure nerves. Cemical irritation is possible but I get nerve block for S1 nerve and it did't help, or there was one day without pain after two days for block. There was also cortisone on this block but no longer help so this one day could be just coincidence. I have get cortisone injection also for SI-joint and piriformis but without any help for the pain. I have seen physioterapist many many times ang get trainee programs, thesa are for back and pelve area.
And yes, I really have seen so many doctors...
Re: Could it be pudendal nerve if no pain in genital area?
Wow, it sounds like you have already tried a bunch of things. I'm sorry nothing has taken away the pain so far.
What did the physiotherapist think is the problem? Is the PT trained in treating pelvic pain and were they able to do a vaginal exam to determine the site of the pain?
Could the gynecologist tell you the location of the pain -- if it is at the pudendal nerve in the vagina?
I think the pudendal nerve comes off of S2, 3, and 4, so the block you had at S1 might not have helped if the pain was from pudendal neuralgia, although I think sometimes the medication can spread some to nearby areas, depending on what volume of medication they used. To diagnose pudendal neuralgia, it might be helpful to have a pudendal nerve block if you can get one done in your country. But it might be difficult to find someone in your area who can do them.
Violet
What did the physiotherapist think is the problem? Is the PT trained in treating pelvic pain and were they able to do a vaginal exam to determine the site of the pain?
Could the gynecologist tell you the location of the pain -- if it is at the pudendal nerve in the vagina?
I think the pudendal nerve comes off of S2, 3, and 4, so the block you had at S1 might not have helped if the pain was from pudendal neuralgia, although I think sometimes the medication can spread some to nearby areas, depending on what volume of medication they used. To diagnose pudendal neuralgia, it might be helpful to have a pudendal nerve block if you can get one done in your country. But it might be difficult to find someone in your area who can do them.
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.